Figure 1
Flowchart of participating physicians.
Table 1
Demographics of participants.
| CHARACTERISTICS | N (%) | PHYSICIANS PRACTICING IN NIGERIA | PHYSICIANS PRACTICING OUTSIDE OF NIGERIA |
|---|---|---|---|
| Total | 49 (100.00) | 35 (71.43) | 14 (28.57) |
| Agea | |||
| 29 or younger | 19 (38.78) | 17 (48.57) | 2 (14.29) |
| 30–39 | 26 (53.06) | 16 (45.71) | 10 (71.43) |
| 40–49 | 4 (8.16) | 2 (5.71) | 2 (14.29) |
| Genderb | |||
| Female | 22 (44.90) | 13 (37.14) | 9 (64.29) |
| Male | 27 (55.10) | 22 (62.86) | 5 (35.71) |
| Were you born in Nigeria? | |||
| Yes | 48 (97.96) | 35 (100.00) | 13 (92.86) |
| No | 1 (2.04) | – | 1 (7.14) |
| Where did you attend high school? | |||
| Nigeria | 48 (97.96) | 34 (97.14) | 14 (100.00) |
| Other | 1 (2.04) | 1 (2.86) | – |
| Where is the medical school you graduated from located? | |||
| Nigeria | 49 (100.00) | 35 (100.00) | 14 (100.00) |
| Other | – | – | – |
| Location of medical school (city, state) | |||
| Abuja | 3 (6.12) | 3 (8.57) | – |
| Benin City, Edo | 2 (4.08) | – | 2 (14.29) |
| Calabar, Cross River | 1 (2.04) | – | 1 (7.14) |
| Elele, Rivers | 1 (2.04) | 1 (2.86) | – |
| Ibadan, Oyo | 4 (8.16) | 1 (2.86) | 3 (21.43) |
| Ilorin, Kwara | 2 (4.08) | – | 2 (14.29) |
| Iwo, Osun | 4 (8.16) | 4 (11.43) | – |
| Jos, Plateau | 19 (38.78) | 19 (54.29) | – |
| Lagos | 3 (6.12) | 2 (5.71) | 1 (7.14) |
| Maiduguri, Borno | 8 (16.33) | 5 (14.29) | 3 (21.43) |
| Port Harcourt, Rivers | 2 (4.08) | – | 2 (14.29) |
| In what year did you graduate from medical school? | |||
| 2010 or before | 5 (10.20) | 2 (5.71) | 3 (21.43) |
| 2011–2015 | 20 (40.82) | 10 (28.57) | 10 (71.43) |
| 2016–2020 | 18 (36.73) | 17 (48.57) | 1 (7.14) |
| 2021 or after | 6 (12.24) | 6 (17.14) | – |
| Did you undergo specialty training (residency training)? | |||
| No | 37 (75.51) | 27 (77.14) | 10 (71.43) |
| Yes | 12 (24.49) | 8 (22.86) | 4 (28.57) |
| If yes, in which country? | |||
| Nigeria | 11 (91.67) | 8 (100.00) | 3 (75.00) |
| UK | 1 (8.33) | – | 1 (25.00) |
| What is your current medical specialty? | |||
| Family/general practice | 18 (36.73) | 12 (34.29) | 6 (42.86) |
| Internal medicine, (e.g., cardiology, respirology, gastroenterology) | 3 (6.12) | – | 3 (21.43) |
| Surgery (e.g., plastic surgery, orthopedic surgery) | – | – | – |
| Pediatrics | – | – | – |
| Psychiatry | 3 (6.12) | 3 (21.43) | |
| Obstetrics/gynecology | 2 (4.08) | 2 (5.71) | – |
| Urology | – | – | – |
| Unspecialized/Medical Officer | 17 (34.69) | 16 (45.71) | 1 (7.14) |
| Other | 6 (12.24) | 5 (14.29) | 1 (7.14) |
[i] a: Categories for ages 50–59 and 60 or older presented but had no observations.
b: Options for “non-binary” and “prefer not to answer” provided but had no observations.
All variable percentages were calculated with missing observations so the total may not add up to 100.00.
Table 2
Job safety, satisfaction, and emigration intent of physicians practicing in Nigeria.
| QUESTION | N (%) |
|---|---|
| Total | 35 (100) |
| What state in Nigeria do you currently practice? | |
| Abuja | 5 (14.29) |
| Adamawa | 3 (8.57) |
| Akwa Ibom | 1 (2.86) |
| Bauchi | 1 (2.86) |
| Benue | 1 (2.86) |
| Cross River | 1 (2.86) |
| Delta | 1 (2.86) |
| Kaduna | 2 (5.71) |
| Katsina | 1 (2.86) |
| Lagos | 4 (11.43) |
| Nasarawa | 1 (2.86) |
| Niger | 1 (2.86) |
| Plateau | 12 (34.29) |
| Rivers | 1 (2.86) |
| How satisfied are you with the overall functioning of your practice? | |
| Extremely Satisfied | 1 (2.94) |
| Somewhat Satisfied | 14 (41.18) |
| Neither satisfied nor Dissatisfied | 5 (14.71) |
| Somewhat Dissatisfied | 10 (29.41) |
| Extremely Dissatisfied | 4 (11.76) |
| Do you ever consider emigrating from Nigeria to practice abroad? | |
| Always | 14 (41.18) |
| Often | 8 (23.53) |
| Sometimes | 11 (32.35) |
| Rarely | 1 (2.94) |
| Never | – |
| Do you have plans to emigrate from Nigeria in the next 5 years? | |
| Yes | 27 (79.41) |
| No | 7 (20.59) |
| Do you feel safe in your place of work? | |
| Yes | 17 (50.00) |
| No | 17 (50.00) |
| How confident are you that your current practice can withstand the surrounding instability in the long run? | |
| Completely Confident | 2 (5.88) |
| Fairly Confident | 3 (8.82) |
| Somewhat Confident | 8 (23.53) |
| Slightly Confident | 5 (14.71) |
| Not Confident at all | 16 (47.06) |
[i] All variable percentages were calculated with missing observations so the total may not add up to 100.00.
Table 3
Practices, job satisfaction, and reasons for emigration for emigrated physicians.
| QUESTION | N (%) |
|---|---|
| Total | 14 (100.00) |
| Where are you currently practicing? | |
| Canada | 3 (21.43) |
| United Kingdom | 8 (57.14) |
| United States | 3 (21.43) |
| Have you ever practiced medicine in Nigeria? | |
| No | – |
| Yes | 14 (100.00) |
| If yes, where/which state? | |
| Abuja | 2 (14.29) |
| Bayelsa, Rivers, Anambra | 1 (7.14) |
| Benue, Abuja | 1 (7.14) |
| Edo | 1 (7.14) |
| Edo, Kaduna | 1 (7.14) |
| Lagos | 1 (7.14) |
| Lagos, Bauchi | 1 (7.14) |
| Lagos, Kwara | 1 (7.14) |
| Osun, Ekiti, Kwara, Ondo | 1 (7.14) |
| Oyo, Adamawa, Osun | 1 (7.14) |
| Plateau | 3 (20.00) |
| Plateau, Ekiti, Abuja | 1 (7.14) |
| How many years did you practice in Nigeria? | |
| < 1 year | – |
| 1 to 2 years | 3 (21.43) |
| 2 to 5 years | 2 (14.29) |
| 5 to 10 years | 8 (57.14) |
| More than 10 years | 1 (7.14) |
| How satisfied were you with the overall functioning of your practice in Nigeria? | |
| Extremely Satisfied | – |
| Somewhat Satisfied | 2 (14.29) |
| Neither satisfied nor Dissatisfied | 1 (7.14) |
| Somewhat Dissatisfied | 6 (42.86) |
| Extremely Dissatisfied | 5 (35.71) |
| Which (if any) of the following factors led you to emigrate from Nigeria? Please select all that apply: | |
| Physician remuneration (pay) | 13 (92.85) |
| Quality of facilities | 12 (85.71) |
| Unrest (sociopolitical, civil and other broad–based unrest) | 11 (78.57) |
| Personal safety | 7 (50.00) |
| Socioeconomic state of the country | 13 (92.85) |
| Quantity and availability of allied health disciplines (e.g., nursing, physical therapy, etc.) | 2 (14.28) |
| Shortcomings in governance and health services management | 10 (71.42) |
| Opportunity for continuing education (residency training, etc.) | 9 (64.28) |
| Workload | 2 (14.28) |
| Other | 4 (28.57) |
| Was the functioning of the health system you practiced in Nigeria affected by unrest (e.g., crises, Boko Haram terrorism, kidnappings, crime etc.)? | |
| No | 6 (42.86) |
| Yes | 8 (57.14) |
| In what year did you arrive in your current country of practice? | |
| Prior to 2017 | 2 (14.29) |
| 2017 | 3 (21.43) |
| 2018 | 2 (14.29) |
| 2019 | 2 (14.29) |
| 2020 | 4 (28.57) |
| Is your current specialty the same as the one in which you trained and/or practiced before emigrating? | |
| No | 7 (50.00) |
| Yes | 7 (50.00) |
| How satisfied are you with the overall functioning of your current practice? | |
| Extremely Satisfied | 4 (28.57) |
| Somewhat Satisfied | 9 (64.29) |
| Neither satisfied nor Dissatisfied | 1 (7.14) |
| Somewhat Dissatisfied | – |
| Extremely Dissatisfied | – |
[i] *All variable percentages were calculated with missing observations so the total may not add up to 100.00.
Figure 2
Pattern of physician movement from medical school to location of current practice(s).
Figure 3
Resilience building themes and framework.